ArticleFrontiers in medicine2026
Admission METS-IR in relation to severe acute pancreatitis among patients with hypertriglyceridemic acute pancreatitis: a retrospective cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hypertriglyceridemic acute pancreatitis (HTG-AP) is accompanied by significant metabolic abnormalities, but few studies have investigated whether a composite measure of this metabolic burden is associated with severe acute pancreatitis (SAP). The metabolic score for insulin resistance (METS-IR), derived from fasting glucose, high-density lipoprotein cholesterol, triglycerides, and body mass index, can be calculated from routinely available clinical data without requiring an insulin assay. However, its association with SAP in HTG-AP remains poorly characterized. Objective: This study investigates the association between admission METS-IR and SAP in patients with HTG-AP and assesses the robustness of this association through subgroup and sensitivity analyses. Methods: We retrospectively assembled a single-center cohort of 456 adults admitted with HTG-AP between January 2019 and July 2025. Logistic regression evaluated METS-IR as a continuous exposure and in quartiles. Restricted cubic splines, subgroup analyses, and sensitivity analyses were performed. Exploratory ROC analyses compared apparent discrimination with TyG, TyG-BMI, and BISAP. Results: SAP occurred in 78 of 456 patients (17.1%). Median METS-IR was 69.99 (IQR, 61.92-83.67) in the SAP group and 58.18 (IQR, 51.47-66.46) in the non-SAP group. In Model 3, each one-point increase in METS-IR was associated with higher odds of SAP (OR, 1.06; 95% CI, 1.04-1.08). After additional adjustment for TG, TG/HDL-C, and TyG, the estimate was attenuated (OR, 1.03; 95% CI, 0.997-1.064; Conclusion: Higher admission METS-IR was independently associated with higher odds of SAP in patients with HTG-AP. METS-IR may provide a readily available measure of metabolic burden for early clinical assessment of patients with HTG-AP, although its clinical utility requires confirmation in prospective multicenter studies.
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